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Pleural effusion exudate

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https://www.readbyqxmd.com/read/29319243/to-study-efficacy-of-medical-thoracoscopy-in-undiagnosed-pleural-effusions
#1
Sachin S Dole, Gauri P Godbole, Himanshu S Pophale
Background: Medical thoracoscopy has received interest in recent past for diagnostic as well as therapeutic uses. In this study we describe our experience with diagnostic medical thoracoscopy in pleural effusions of undiagnosed etiology. Objectives: 1.To detect diagnostic yield of medical thoracoscopy in pleural effusions of unknown etiology. 2.To find complication rate in these patients. Methodology: In a retrospective analysis of thoracoscopic procedures performed between March 2011 and December 2014, diagnostic yield and complications of thoracoscopic pleural biopsy for achieving a diagnosis in undiagnosed pleural effusions were evaluated...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29297451/cxcr3-ligands-in-pleural-fluid-as-markers-for-the-diagnosis-of-tuberculous-pleural-effusion
#2
W Chung, Y Jung, K Lee, J Park, S Sheen, K Park
SETTING: A tertiary care academic medical centre. OBJECTIVE: To evaluate the clinical usefulness of C-X-C motif chemokine receptor 3 (CXCR3) ligands in tuberculous pleural effusion (TPE). DESIGN: We recruited 336 patients with pleural effusion due to various causes. Concentrations of interferon-gamma (IFN-γ) and the CXCR3 ligands CXCL9 and CXCL11 were determined using enzyme immunoassays; adenosine deaminase (ADA) activity was measured in pleural fluid and serum...
December 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29231161/pleural-and-pericardial-effusion-in-a-long-term-pd-patient-a-defying-diagnosis%C3%A2
#3
Iolanda Godinho, Joana M Dias, Natacha Rodrigues, Hugo Silva, Sofia Jorge, Cristina P Abreu, José A Lopes
Peritoneopleural shunt is an uncommon complication of peritoneal dialysis (PD) usually presenting early as a right pleural transudate. Peritoneopericardial shunt is an even rarer entity in PD, almost never occurring spontaneously. We present the case of a 37-year-old woman on PD for 24 months exhibiting a left pleural and pericardial effusion following pneumonia. Pleural fluid was initially compatible with an exudate with a high glucose concentration and later with a transudate. In order to clarify the suspicion of an ongoing shunt an abdominal scintigraphy was performed confirming the diagnosis of a peritoneopleuropericardial communication...
December 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29218743/repeatability-of-pleural-adenosine-deaminase-measurements-in-diagnostic-evaluation-of-pleural-effusions
#4
Ourania S Kotsiou, Panagiota Tzortzi, Rafailia A A Beta, Athanasios Kyritsis, Konstantinos I Gourgoulianis
BACKGROUND: A follow-up thoracentesis is proposed in suspected atypical tuberculosis cases. The study aimed to define the variability of pleural ADA values across repeated thoracenteses in different types of pleural effusions (PEs) and to evaluate whether ADA variance, in regard to the cutoff value of 40 U/L, affected final diagnosis. METHODS: A total of 131 patients with PEs of various etiologies underwent three repeated thoracenteses. ADA values were subsequently estimated...
December 7, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#5
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29208371/integrated-semi-targeted-metabolomics-analysis-reveals-distinct-metabolic-dysregulation-in-pleural-effusion-caused-by-tuberculosis-and-malignancy
#6
Nanying Che, Yan Ma, Huabin Ruan, Lina Xu, Xueying Wang, Xinting Yang, Xiaohui Liu
BACKGROUND: Tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) are the 2 most frequent causes of exudative pleural effusions (PEs). However, the clinical differentiation is challenging. METHODS: Metabolic signatures in pleural effusion from 156 patients were profiled. An integrated semi-targeted metabolomics platform was incorporated for high throughput metabolite identification and quantitation. In this platform, orbitrap based mass spectrometry with data dependent MS/MS acquisition was applied in the analysis...
December 5, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29197468/characteristics-of-patients-with-myelomatous-pleural-effusion-a-systematic-review
#7
V Riveiro, L Ferreiro, M E Toubes, A Lama, J M Álvarez-Dobaño, L Valdés
BACKGROUND: Myelomatous pleural effusion (MPE) is rare in multiple myeloma, and therefore its characteristics are not well defined. METHODS: A systematic review (4 online databases) was conducted of articles describing the clinical characteristics of patients with MPE, pleural effusion's biochemical characteristics and treatment efficacy. We analysed isolated cases and small retrospective series. RESULTS: We included 98 articles with a total of 153 patients with MPE...
November 29, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29189866/-role-of-surgery-in-saprochaete-capitata-s-capitata-sepsis-in-a-patient-with-acute-myeloid-leukemia
#8
Jasna Radich R, Carlos Álvarez Z, Ana Valenzuela R, Felipe Castillo H, Francisco Moraga V, Jorge Castillo A
Saprochaete capitata (S. capitata) fungal sepsis is a severe condition with a clinical presentation that is similar to other yeast originated fungal sepsis. It is observed in patients with hematological malignancies such as acute myeloid leukemia and neutropenia. We report a 23 year old male presenting with cough, fever and malaise. A bone marrow biopsy led to the diagnosis of acute myeloid leukemia. During the first cycle of chemotherapy the patient presented fever: blood cultures were positive for Klebsiella pneumoniae...
August 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29166899/medical-thoracoscopy-for-exudative-pleural-effusion-an-eight-year-experience-from-a-country-with-a-young-population
#9
Merlin Thomas, Wanis H Ibrahim, Tasleem Raza, Kamran Mushtaq, Adeel Arshad, Mushtaq Ahmed, Salma Taha, Saber Al Sarafandi, Hanfa Karim, Hisham A Abdul-Sattar
BACKGROUND: With the exception of areas with high prevalence of tuberculosis, medical thoracoscopy is becoming the diagnostic modality of choice for exudative pleural effusions. The aims of this study were to determine the diagnostic yield and safety of medical thoracoscopy for exudative pleural effusions and ascertain the etiology of such effusions in Qatar. METHODS: This is a retrospective-descriptive study of 407 patients who underwent diagnostic medical thoracoscopy for exudative pleural effusions from January, 2008 till December, 2015 at the only tertiary referral center performing this procedure in Qatar...
November 22, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29157885/development-and-validation-of-a-scoring-system-for-the-identification-of-pleural-exudates-of-cardiac-origin
#10
José M Porcel, Lucia Ferreiro, Carme Civit, Luis Valdés, Aureli Esquerda, Richard W Light, Silvia Bielsa
BACKGROUND: Light's criteria misclassify about 30% of cardiac effusions as exudates, possibly leading to unnecessary testing. Our purpose was to derive and validate a scoring model to effectively identify these falsely categorized cardiac effusions, in the setting of natriuretic peptide lacking data. METHODS: We retrospectively analyzed data from 3182 patients with exudative pleural effusions based on Light's criteria, of whom 276 had heart failure (derivation set)...
November 17, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29063807/unilateral-pleural-effusion-as-the-sole-clinical-presentation-of-severe-ovarian-hyperstimulation-syndrome-a-systematic-review
#11
Mohamad Irani, Alex Robles, Vinay Gunnala, Pak Chung, Zev Rosenwaks
The pathophysiology of isolated pleural effusion in ovarian hyperstimulation syndrome (OHSS) is not well defined. The objective of the current review is to delineate the pathophysiology, risk factors, preventive measures, and therapeutic options of isolated pleural effusion in severe OHSS. Major databases were searched until June 2016. Studies evaluating women who presented with pleural effusion as the sole extra-ovarian manifestation of severe OHSS were included. Data were extracted from 24 articles encompassing 30 reported cases...
October 24, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29050127/-immune-related-pneumonitis-caused-by-programmed-death-1-inhibitor-pembrolizumab-a-case-report-and-literature-review
#12
Y L Chen, J Zhao, R Jia, H Y Wang, J Zheng, C Q Bai, M Z Wang, J M Xu
Objective: To investigate the risk factors, clinical manifestations, radiological features, diagnosis, treatment and prognosis of immune-related pneumonitis caused by programmed death-1(PD-1)/PD-L1 inhibitors. Methods: The clinical data of immune-related pneumonitis caused by PD-1 inhibitor Pembrolizumab in a patient with advanced esophageal carcinoma admitted to the 307(th) Hospital of Chinese People's Liberation Army was retrospectively analyzed and the related literatures were reviewed. We searched Medline database using the keywords"PD-1 inhibitor","PD-L1 inhibitor","Pembrolizumab","Nivolumab","Atezolizumab"combined with"Pneumonitis"by Mar 31, 2017...
October 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#13
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29021929/rare-presentation-of-a-posterior-mediastinal-cystic-schwannoma-as-a-large-pleural-effusion
#14
Mujtaba Mubashir, Abdus Salam, Amyn Sonawalla, Huma Fatima, Saulat H Fatimi
A 46-year-old man presented with shortness of breath and recurrent, left-sided pleural effusions. A computed tomography (CT) scan of the chest showed a large, left-sided pleural effusion with a mass in the posterior mediastinum. A pleural tap showed lymphocytic exudate. The biopsy of the mass was inconclusive. A left posterolateral thoracotomy was performed, which showed a large posterior mediastinal mass adherent to the left lung. The mass was completely excised and the histopathology proved it to be giant predominantly cystic schwannoma...
August 10, 2017: Curēus
https://www.readbyqxmd.com/read/28967190/multimodality-imaging-characteristics-of-tension-pyopneumothorax-secondary-to-pulmonary-carcinoma-in-a-cat
#15
Jaehwan Kim, Hakyoung Yoon, Soyoung Kim, Kidong Eom
A 3-year-old Himalayan cat was presented with respiratory distress. Radiography showed multiple gas opacity foci, with the locations dependent on patient positioning, and severe pleural effusion with a contralateral mediastinal shift. A large volume of fluid and air was aspirated, and the fluid components were consistent with a nonseptic exudate. A pulmonary mass, pleural nodules, and an air-fluid interface with air bubbles trapped in fibrous septations were identified using thoracic ultrasonography and CT...
October 1, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28965174/lactate-determination-in-pleural-and-abdominal-effusions-a-quick-diagnostic-marker-of-exudate-a-pilot-study
#16
Giovanni Porta, Fabio G Numis, Valerio Rosato, Antonio Pagano, Mario Masarone, Giorgio Bosso, Claudia Serra, Luca Rinaldi, Maria C Fascione, Annalisa Amelia, Fiorella Paladino, Fernando Schiraldi
Pleural or abdominal effusions are frequent findings in ICU and Internal Medicine patients. Diagnostic gold standard to distinguish between transudate and exudate is represented by "Light's Criteria," but, unfortunately, the chemical-physical examination for their calculation is not a rapid test. Pursuing an acid-base assessment of the fluid by a blood-gas analyzer, an increase of lactate beyond the normal serum range is reported in the exudative effusions. The advantages of this test are that it is a very fast bed-side test, executable directly by the physician...
September 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28957888/usefulness-of-medical-thoracoscopy-in-the-management-of-pleural-effusion-caused-by-chronic-renal-failure
#17
Sara Colella, Federica Fioretti, Chiara Massaccesi, Gian L Primomo, Gianluca Panella, Vittorio D'Emilio, Riccardo Pela
INTRODUCTION: Although pleural effusion (PE) can be caused by several pathologies like congestive heart failure, infections, malignancies, and pulmonary embolism, it is also a common finding in chronic kidney disease (CKD). Diagnostic thoracentesis is of limited value in the differential diagnosis, and the role of more invasive investigations like medical thoracoscopy (MT) is still unclear. AIM: To evaluate the usefulness of MT in unexplained PE in CKD. MATERIALS AND METHODS: In the electronic database of our Institution, we retrospectively searched for patients with CKD who underwent MT for unexplained PE between January 2008 and August 2016...
October 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28893806/low-dose-intrapleural-alteplase-without-deoxyribonuclease-in-complicated-parapneumonic-effusion-case-series-and-literature-reviews
#18
Carol Lai, Nurashikin Mohammad, Tidi Maharani Hassan, Mohamed Faisal Abdul Hamid
This case series reviews two cases of elderly patients who presented with fever, cough and shortness of breath. Clinical examinations and initial chest radiographs confirmed unilateral pleural effusion. Thoracenteses were consistent with exudative pleural effusion. We commenced intravenous antibiotics treating for parapneumonic effusions. The first case showed persistent effusion despite drainage, and the second case had a little aspirate from pleural tapping. Subsequent ultrasound of the thorax showed multiloculated effusions...
September 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28869229/endoscopic-ultrasound-guided-evaluation-of-the-pleura-and-cases-of-pleural-effusion
#19
REVIEW
Malay Sharma, Chittapuram Srinivasan Rameshbabu
The most efficient and cost-effective approach for the diagnosis of pleural exudates remains uncertain and is a subject of controversy. Essential factors to be considered include the respective diagnostic yields of thoracocentesis, closed pleural biopsy, and thoracoscopy. The role of endoscopic ultrasound (EUS) of the esophagus as a modality for the evaluation of pleural exudates has not yet been evaluated. The applied anatomy of the pleura has been discussed. The techniques involved in the EUS imaging of different aspects of the pleura in normal cases and in cases with pleural effusion are elaborated...
September 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28844060/diagnostic-accuracy-of-interleukin-27-for-tuberculous-pleural-effusion-two-prospective-studies-and-one-meta-analysis
#20
Wen Wang, Qiong Zhou, Kan Zhai, Yao Wang, Jing-Yuan Liu, Xiao-Juan Wang, Zhen Wang, Jian-Chu Zhang, Zhao-Hui Tong, Huan-Zhong Shi
BACKGROUND: Accurate differentiating diagnosis is essential for choosing treatment for exudative pleural effusions. OBJECTIVE: To establish the diagnostic accuracy of interleukin 27 for tuberculous pleural effusion (TPE). METHODS: First, the concentrations of pleural interleukin 27, interferon-gamma and adenosine deaminase were compared between 51 patients with TPE and 103 with non-TPEs (Beijing cohort), and their diagnostic values were evaluated...
August 26, 2017: Thorax
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